Derik S Evenson
PORT HURON PHYSICIANS MEDICAL GROUP PC


Address: 1985 Gratiot Blvd, Marysville, MI 48040-2215
Phone: 8103640692

Derik S Evenson (NPI# 1295910651, PAC ID# 1456436427) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1295910651
PAC ID by PECOS 1456436427
Professional Enrollment ID I20170626000212
Full Name Derik S Evenson
Organization Legal Name PORT HURON PHYSICIANS MEDICAL GROUP PC
Address 1985 Gratiot Blvd
Marysville
MI 48040-2215
Phone Number 8103640692
Gender M
Graduation Year 2007
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 0840507802
Number of Group Practice Members 8
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
230031 LAKE HURON MEDICAL CENTER
230216 MCLAREN PORT HURON

Other Locations

Address Phone Organization
1985 Gratiot Blvd, Marysville, MI 48040-2215 8103640692 PORT HURON PHYSICIANS MEDICAL GROUP PC

Organization Information

Organization Legal Name PORT HURON PHYSICIANS MEDICAL GROUP PC
Physicians 13

Physicians with the same organization

Name Specialty Organization Address
Robert J Sachs Internal Medicine Port Huron Physicians Medical Group PC 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884
Dawn Elaine Morey General Surgery Port Huron Physicians Medical Group PC 2609 Electric Ave B, Lake Huron Med Grp, Port Huron, MI 48060-6589
Patrick A Kut Family Medicine Port Huron Physicians Medical Group PC 2603 Electric Ave, 3 Lake Huron Med Grp, Port Huron, MI 48060-6588
Philip Milan Matich Family Medicine Port Huron Physicians Medical Group PC 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884
Gaurav Bhalla Internal Medicine Port Huron Physicians Medical Group PC 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884
Aaron J Overly General Surgery Port Huron Physicians Medical Group PC 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884
Shilpin A Mehta General Surgery Port Huron Physicians Medical Group PC 2609 Electric Ave B, Lake Huron Med Grp, Port Huron, MI 48060-6589
Krishna D Valjee General Surgery Port Huron Physicians Medical Group PC 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884
Sushma Reddy Endocrinology Port Huron Physicians Medical Group PC 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884
Arunthathi T Stallwood Internal Medicine Port Huron Physicians Medical Group PC 1985 Gratiot Blvd, Marysville, MI 48040-2215

Office Location

Street Address 1985 GRATIOT BLVD
City MARYSVILLE
State MI
Zip 48040-2215

Physicians in the same location

Name Specialty Organization Address
Rigel M Galera Family Medicine Vpa PC 1985 Gratiot Blvd, C, Marysville, MI 48040-1200
Edgar A Pou Family Medicine Vpa PC 1985 Gratiot Blvd, C, Marysville, MI 48040-1200
Joji Alex Nurse Practitioner Vpa PC 1985 Gratiot Blvd, C, Marysville, MI 48040-1200
Arunthathi T Stallwood Internal Medicine Port Huron Physicians Medical Group PC 1985 Gratiot Blvd, Marysville, MI 48040-2215
Amgad L Nashed Awad Family Practice Iah of Michigan Pllc 1985 Gratiot Blvd, Marysville, MI 48040-2215

Physicians in the same zip code

Name Specialty Organization Address
Ramica Ford Chiropractic 1124 Gratiot Blvd, Marysville, MI 48040-1133
Jessica A Onufrak Nurse Practitioner Physician Healthcare Network PC 1600 Gratiot Blvd, Marysville, MI 48040-1145
Michelle M Rousseau Psychologist, Clinical Emca Counseling PC 1600 Gratiot Blvd, Bldg B, Marysville, MI 48040-1145
Courtney L Mcclellan Clinical Social Worker Emca Counseling PC 1600 Gratiot Blvd, Bldg B, Marysville, MI 48040-1145
Dianna L Pratt Psychologist, Clinical Emca Counseling PC 1600 Gratiot Blvd, Bldg B, Marysville, MI 48040-1145
Katrina Louise Stachowiak Physician Assistant Physician Healthcare Network PC 1600 Gratiot Blvd, Marysville, MI 48040-1145
Todd Patrick Stachowiak Physician Assistant Physician Healthcare Network PC 1600 Gratiot Blvd, Marysville, MI 48040-1145
Rodney D Mclane Chiropractic 1600 Gratiot Blvd, Suite 6, Marysville, MI 48040-1145
Kelly Ann Wright Physician Assistant Physician Healthcare Network PC 1600 Gratiot Blvd, Marysville, MI 48040-1145
Daniel Joseph Wilhelm Pediatric Medicine Physician Healthcare Network PC 1600 Gratiot Blvd, Marysville, MI 48040-1145
Find all physicians in zip 48040

Competitor

Search similar physicians

City MARYSVILLE
Zip Code 48040
Specialty NURSE PRACTITIONER
City + Specialty MARYSVILLE + NURSE PRACTITIONER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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